Minerva anestesiologica
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Minerva anestesiologica · May 2013
Randomized Controlled Trial Comparative StudyPolyurethane does not protect better than polyvinyl cuffed tracheal tubes from microaspirations.
Mechanically ventilated patients are prone to develop ventilator associated pneumonia due to microaspirations of subglottic secretions around the endotracheal tube cuff (usually constructed of polyvinyl material). A novel polyurethane cuff has been designed to minimize these leakages. The aim of the study was to compare the tracheal sealing capacities between the two tubes. ⋯ These preliminary results suggest that both tubes are poorly effective in preventing microaspirations.
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Minerva anestesiologica · May 2013
ReviewThe usage of the Boussignac continuous positive airway pressure system in acute respiratory failure.
Traditionally, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices have been used to treat patients in acute respiratory failure. However they require an electric power source, are relatively large in size, and may be difficult to use in prehospital settings. The recently introduced Boussignac CPAP system is capable of delivering 10 cmH2O of CPAP, is compact, portable and requires only an oxygen source. ⋯ In one study, implementing Boussignac CPAP reduced intubation rate and hospital stay. Most hospital staff found Boussignac CPAP easy to use and complication rates were low. Boussigac CPAP is a useful device in the treatment of patients with acute respiratory failure, especially in the prehospital setting.
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreconditioning effects of the anesthetic administered to the donor on grafted kidney function in living donor kidney transplantation recipients.
In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys against renal ischemia-reperfusion injury. ⋯ The inhalational anesthetic administered to donors does not improve grafted kidney function in recipients undergoing LDKT to a greater extent than propofol.
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Minerva anestesiologica · May 2013
ReviewDonation after cardiac death: is a "paradigm shift" feasible in Italy?
Donation after cardiac death (DCD) is one of the growing strategies to overcome the problem of organ shortage. Cardiac death is defined as "irreversible cessation of circulatory and respiratory function"; the time interval to define irreversibility of cardiac death, the peculiarity of consent, and the framework of end-of-life decision making are the most compelling ethical issues which have been raised with DCD. National protocols that balance medical, ethical, and social issues are mandatory to guide transplant care professionals. ⋯ This time negatively affects donation after cardiac death because warm ischemic time (WIT) - the most important predictor of grafts' poor outcome - is prolonged. However, this time seems to be prudential to define the irreversibility of death and to respect the "dead donor rule", as established by the National Committee of Bioethics. National reference protocols regulating DCD practice are therefore a compelling issue.